Recent trends show noticeable increases in the involvement of girls in the juvenile justice system. A disproportionately high number of these girls have co-occurring mental health diagnoses that are related in part to their victimization through sexual, physical, and emotional abuse. Many girls also come from unstable families, whereas others are homeless, and a significant number have substance abuse problems, posttraumatic stress disorder, depression, and anxiety disorders. Not surprisingly, they have complex school histories, and they are at high risk for school failure and dropping out. In this article we discuss the unique challenges of girls with co-occurring disorders as they come into contact with systems that are not prepared to meet their needs. Further, concerns regarding inequity are discussed from the perspective of this vulnerable population: The persistent disconnect between the treatment needs of girls and the services provided in the juvenile justice system draws attention to the inequity of this system.